Home Business Taking a Look: Town Officials Tour Blowing Rock’s “Chestnut Ridge” Project

Taking a Look: Town Officials Tour Blowing Rock’s “Chestnut Ridge” Project

If the orientation of things at Chestnut Ridge isn’t completely apparent yet, Town officials were guided along by charts. Photo by David Rogers for Blowing Rock News

By David Rogers – May 6, 2015. BLOWING ROCK, NC It seemed like construction workers were in, or near, every part of the project when we visited Chestnut Ridge with the Blowing Rock Town Commissioners and Appalachian Regional Healthcare System (ARHS) officials on Monday, so it’s not surprising that Blowing Rock’s newest healthcare facility is beginning to take shape.

There are walls. There are big square openings where windows will be. There are structures where roofs will soon protect patients and employees from the elements. Without question, Chestnut Ridge will soon be an operating reality. No longer is it a question of whether or not the facility will be built, as some naysayers predicted. Instead, it is just a matter of when.

We are 43% complete and on schedule.

ARHS’ Rob Hudspeth, center, points out features to Scott Fogleman, foreground, and Doug Matheson. Photo by David Rogers for Blowing Rock News

In touring the facility with Town Commissioners, Blowing Rock News asked ARHS’ project manager Maran Sigmon whether all of the late winter and early spring rains had put things behind. He replied, “The original scheduling for construction provided for those kinds of delays, so not really. There was a lot of rain, but we counted on that and there were also some days in there where we could pour cement. We are currently 43% complete and on schedule.”

For a project that began construction in August 2014, Hickory Construction and ARHS have made remarkable progress. As he toured the facility, Commissioner Doug Matheson noted that so often in these construction projects it seems like “forever” to see any real progress because so much has to be done at or below ground level, such as foundation work and infrastructure for utilities.

Commissioner Ray Pickett noticed right away some of the construction features that will make Chestnut Ridge safer for patients and employees through the use of fire resistant materials, as well as more comfortable. It will also be quieter between rooms because of the use of floor-to-ceiling insulation materials in the walls between the rooms.

There are spots where the walking is “tricky”, here where a wire mesh covers a deep corrugated surface. Photo by David Rogers for Blowing Rock News

In addition to Mr. Pickett and Mr. Matheson, Blowing Rock was represented by Town Manager Scott Fogleman and Police Chief Tony Jones.

Leading the tour from Appalachian Regional Healthcare System, were Rob Hudspeth, Sr. Vice President of System Advancement and Dr. Herman Godwin, Sr. Vice President and Medical Director. Others in the ARHS contingent were Jessica Powell, Development Officer, and Gillian Baker, Vice President of Corporate Communications.

Among the greatest challenges in healthcare delivery are the quality of care and the cost of care.

Dr. Godwin spoke with Blowing Rock News after the tour about the importance of the Chestnut Ridge Post-Acute Care Facility and its role in the High Country’s healthcare system.

Asked about the fast-changing landscape in healthcare and Chestnut Ridge’s role in the High Country, Dr. Godwin was quick to crystallize the opportunity addressed by Blowing Rock’s new healthcare capability.

Town Commissioner Doug Matheson takes a closer look inside one of the rooms. Photo by David Rogers for Blowing Rock News

“Among the greatest challenges today in healthcare delivery,” Dr. Godwin reported, “are the quality of care, as well as the cost of care to the patient and to third party payers, such as Medicare, Medicaid, and commercial insurance companies. In our analysis of a post-acute care facility like Chestnut Ridge we’ve been able to show, for example, that a heart failure patient kept for 10 days at Watauga Medical Center would generate charges in excess of $50,000. On the other hand, let’s assume that same individual gets the first three days of care at Watauga Medical Center and, after stabilization, is able to come to the post-acute care facility for the same remaining seven days of care.  In this alternative scenario, the total charges incurred would be $18,000 to $19,000, or just over a third of the patient’s cost should he remain at Watauga Medical Center for the full 10-day period.

“The key,” Dr. Godwin added, “is to provide superb quality of care to someone who has been in the hospital but needs post-acute care. That person doesn’t necessarily need all the specialized resources that are available in an acute care hospital.”

Officials check out the first floor. Photo by David Rogers for Blowing Rock News

Blowing Rock News asked Dr. Godwin about the impact on the costs to the healthcare system, and he was quick to say, “There is no question about it: the system saves money and the patient saves money. He or she will receive the same high quality treatment at Chestnut Ridge as would be provided at the hospital. If that patient is having a serious issue such as a heart problem, he or she needs to be in the hospital. But once stabilized, in most cases the patient will only need specialized and professional supervision while recovering. That’s where post-acute care comes in.

The key is to provide superb quality of care to someone who has been in the hospital but needs post-acute care.

“By employing a facility like Chestnut Ridge,” continued Godwin, “we improve care for the patient, but are also more efficient. The reason that acute care at the hospital has such a high overhead is that there are features such as the emergency room, which is open 24 hours a day, seven days a week, 365 days a year. In addition, costly operating suites at the hospital are busiest on weekdays but still being utilized on the weekends. There is the overall size of an acute care facility like Watauga Medical Center. The overhead includes employing the necessary personnel to staff that facility. There are many, many factors that increase the cost at a hospital facility compared to a post-acute care facility.

Dr. Herman Godwin is Sr. VP of ARHS and Medical Director for Appalachian Regional Healthcare System. Photo by David Rogers for Blowing Rock News

“Having a professionally staffed and equipped facility like Chestnut Ridge,” said Godwin, “offers the potential for huge savings for the hospital system, for the patient, and for the third party payer who provides most of the payment.”

Godwin went on to observe that Chestnut Ridge represents a major innovation in the delivery of patient care. “In its day, when it was built back in the 50’s, Blowing Rock Hospital was state of the art. But in the present day it is not possible to deliver the kind of efficient care at the old facility that we will be able to provide at Chestnut Ridge.”

“Chestnut Ridge will deliver excellent healthcare,” suggested Dr. Godwin, “but it will also be more efficient. There will be no overhead associated with having to staff and supply an emergency room or an operating room. There will not be the intensity of services provided at a hospital facility. Instead, there will be the level of service that is appropriate for the patient being treated.”

Chestnut Ridge will deliver excellent healthcare…there will be a level of service that is appropriate for the patient being treated.

Town Manager isn’t taking a “selfie.” He is getting pics for the Commissioners and Mayor who were unable to attend. Photo by David Rogers for Blowing Rock News

“Keep in mind,” the dean of High Country healthcare noted, “the same dedicated people who currently deliver such wonderful care at Blowing Rock Hospital will be providing the same high quality care in a present day, state-of-the-art facility at Chestnut Ridge. We will be transferring approximately 110 jobs to Chestnut Ridge and will likely be creating even more. “

He pointed out, “You also need to keep in mind that patients and their families today are consumers of healthcare. They have choices. Rightly or wrongly, there is a perception among consumers that newer and more modern facilities are often better. Ultimately, we have to compete with facilities off the mountain for long term and rehabilitative care. Those facilities are often newer or more modern than the current Blowing Rock facility. We never want people to get sick or injured, but when they do Chestnut Ridge will actually keep, as well as attract more patients to the High Country and this will have an overall positive economic impact on the region.”

From this perspective on what is currently a “rooftop”, the scale of the project is pretty big. Photo by David Rogers for Blowing Rock News

ARHS officials estimated that the construction of Chestnut Ridge should be completed by March 2016, at which point it will be inspected by various state regulatory agencies, prior to opening in the summer.


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